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By simplest definition, shock is a state of inadequate substrate delivery at the cellular level.
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The credibility of "dueling experts" testifying before a jury often determines the outcome of a lawsuit alleging malpractice by an emergency physician, but in fact, expert witnesses typically get involved weeks before a case is even filed.
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Historically, emergency department (ED) triage was rarely a high-risk issue for hospitals, primarily because short waiting times resulted in all patients being seen quickly by the emergency physicians. Today, the combination of overcrowding, markedly prolonged waiting times, increasing numbers of patients leaving the ED before examination, the nursing shortage, diminishing financial support, and federal Emergency Medical Treatment and Active Labor Act (EMTALA) mandates make triage a very dangerous encounter for the patient and a fertile source of litigation against providers.
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We should all be aware of the four components of malpractice the physician had a duty, breached the duty, there was harm to the patient, and the harm was caused by the breach of duty.
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Every trial usually comes down to a "battle of the experts," with the jury judging the credibility of the experts and making their decision. Consider these important factors, advises Linda M. Stimmel, a partner with the Dallas, TX-based law firm of Stewart Stimmel: Experience, education, training, the effectiveness of how the expert communicates with the jurors, and the bedside manner of the expert. "Even how the expert is dressed may affect their credibility."
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This is the second of a two-part series on delayed diagnoses in the ED. This month, we report on legal risks involving time-dependent medications and interventions.
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